Objective:Health-care workers(HCWs)are known to be at high risk for occupational biological hazards,and this includes exposure to mycobacterium tuberculosis(TB)which can result in either active or latent TB infection(...Objective:Health-care workers(HCWs)are known to be at high risk for occupational biological hazards,and this includes exposure to mycobacterium tuberculosis(TB)which can result in either active or latent TB infection(LTBI).This study aims to provide an overview of the incidence of LTBI among HCWs in Brunei Darussalam,to examine associated risk factors,and to evaluate LTBI treatment compliance.Materials and Methods:This is a retrospective cross-sectional study which was conducted using data from January 2018 to December 2021,on notified cases of LTBI in HCWs which identified 115 cases.Demographic data,underlying medical conditions,and compliance to treatment were assessed through reviews of their electronic health records.Results:The incidence of LBTI was 14.6/year/1000 HCWs.The incidence rate reached a high of 24.6/1000 in 2020,and majority of cases were in the older age groups.There was good treatment acceptance and compliance(82.6%),and this was observed to be significantly higher in females than males(P=0.02).Conclusion:This study showed an average incidence of LTBI of 14.6/1000 HCWs over 4 years and high LTBI treatment acceptance(82.6%)and compliance.Emphasis on infection prevention and control measures in health-care settings and actions to increase awareness of LTBI are crucial interventions toward reducing the burden of LTBI.展开更多
Objective:This paper aims to explore the effect of individualized nursing intervention on patients with active tuberculosis(ATB)and latent tuberculosis infection(LTBI).Methods:The nursing study started in January 2020...Objective:This paper aims to explore the effect of individualized nursing intervention on patients with active tuberculosis(ATB)and latent tuberculosis infection(LTBI).Methods:The nursing study started in January 2020 and ended in January 2023.A total of 60 patients with ATB and LTBI were included,and they were divided into two groups according to the intervention schemes selected for control testing,each with 30 cases.The intervention program selected for group A was routine care,and for group B was individualized nursing.The proportion of adverse reactions,changes in the level of lung items,self-management outcomes and satisfaction were evaluated and compared.Results:After evaluating the proportion of adverse reactions,the total proportion of ATB and LTBI in group B was lower than that in group A(P<0.05).Based on the evaluation and testing of the expiratory flow(EF),expiratory volume(EV),and vital capacity(VC)after the intervention,these levels in group B showed higher outcomes than those in group A(P<0.05).The scores in terms of living habits,sleep,diet,and compliance in group B were higher than those in group A(P<0.05).The total proportion of the satisfaction of ATB and LTBI patients in group B was higher than that in group A(P<0.05).Conclusion:After the intervention of individualized nursing measures in patients with ATB and LTBI,it was found that it can not only play a positive role in the prevention and control of adverse reactions,but also improve their lung function,and promote their self-management,with good satisfaction level,thus it has high research and clinical application values.展开更多
<b><span style="font-family:Verdana;">Introduction: </span></b><span><span><span style="font-family:;" "=""><span style="font-family...<b><span style="font-family:Verdana;">Introduction: </span></b><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">The diagnosis of latent tuberculosis infection (LTBI) is based on secular ways: chest radiography and tuberculin skin test (TST). In front of a recent enthusiasm for LTBI, this paper reports a historical perspective of this concept. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Bibliometric analysis and literature review from medi</span><span style="font-family:Verdana;">cal databases, using the terms “latent tuberculosis infection (“LTBI”), “prim</span><span style="font-family:Verdana;">ary tuberculosis”, “tuberculin skin test”, “tuberculosis”, and from reference books on tuberculosis. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">In the PubMED/MEDLINE search for LTBI, a total of 7787 articles were found between 1901 and 2020, 95% </span><span style="font-family:Verdana;">from 2000 to 2020. In the first part of the 20</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century, </span><span style="font-family:Verdana;">LTBI term was used for sub-clinical tu</span><span><span style="font-family:Verdana;">berculosis disease, the latency being also called “</span><i><span style="font-family:Verdana;">primary tuberculosis</span></i><span style="font-family:Verdana;">” or <i>“</i></span><i><i><span style="font-family:Verdana;">ab</span></i></i></span><i><i><span style="font-family:Verdana;">ortive tuberculosis infection</span></i><span style="font-family:Verdana;">”</span></i>. <span style="font-family:Verdana;">From 1960, randomized prospective therapeutic studies mentioned </span></span><span><i></i></span><i><span style="font-family:Verdana;">“</span><i><span style="font-family:Verdana;">tuberculosis chemoprophylaxis</span></i><span style="font-family:Verdana;">”</span></i><span style="font-family:Verdana;">. By the end of the 20</span></span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century,</span><span style="font-family:Verdana;"> the epidemic of AIDS impeded tuberculosis decrease, making LTBI </span><span><span style="font-family:Verdana;">search more efficient. In 2000, the <i></i></span><i><i><span style="font-family:Verdana;">American Thoracic Society</span></i></i></span><i><span style="font-family:Verdana;"></span></i></span><span><span style="font-family:Verdana;"> and the <i></i></span><i><i><span style="font-family:Verdana;">Center</span></i></i></span><i><i><span style="font-family:Verdana;">s </span><span style="font-family:Verdana;">for Disease Controls and Prevention</span></i><span style="font-family:Verdana;"></span></i><i><span> </span></i><span style="font-family:Verdana;">proposed the systematic used of LTBI, rel</span><span style="font-family:Verdana;">ayed through public health policies. A significant higher scientific produc</span><span style="font-family:Verdana;">tion about LT</span><span style="font-family:Verdana;">BI was noted, supported by IGRA tests comm</span><span><span style="font-family:Verdana;">ercialization. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In the recent years, health public policies, combined with epidemiologic and economic factors, strengthened the use of LTBI terminology.</span></span>展开更多
Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particular...Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates.展开更多
Student contacts of tuberculosis(TB)cases are susceptible to latent tuberculosis infection(LTBI),and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo...Student contacts of tuberculosis(TB)cases are susceptible to latent tuberculosis infection(LTBI),and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment.展开更多
Objective Current commercially available immunological tests cannot be used for discriminating active tuberculosis(TB)from latent TB infection.To evaluate the value of biomarker candidates in the diagnosis of active T...Objective Current commercially available immunological tests cannot be used for discriminating active tuberculosis(TB)from latent TB infection.To evaluate the value of biomarker candidates in the diagnosis of active TB,this study aimed to identify differentially expressed genes in peripheral blood mononuclear cells(PBMCs)between patients with active TB and individuals with latent TB infection by transcriptome sequencing.Methods The differentially expressed genes in unstimulated PBMCs and in Mycobacterium tuberculosis(Mtb)antigen-stimulated PBMCs from patients with active TB and individuals with latent TB infection were identified by transcriptome sequencing.Selected candidate genes were evaluated in cohorts consisting of 110 patients with TB,30 individuals with latent TB infections,and 50 healthy controls by quantitative real-time RT-PCR.Receiver operating characteristic(ROC)curve analysis was performed to calculate the diagnostic value of the biomarker candidates.Results Among the differentially expressed genes in PBMCs without Mtb antigen stimulation,interferon-induced protein with tetratricopeptide repeats 3(IFIT3)had the highest area under curve(AUC)value(0.918,95%CI:0.852-0.984,P<0.0001)in discriminating patients with active TB from individuals with latent TB infection,with a sensitivity of 91.86%and a specificity of 84.00%.In Mtb antigen-stimulated PBMCs,orosomucoid 1(ORM1)had a high AUC value(0.833,95%CI:0.752-0.915,P<0.0001),with a sensitivity of 81.94%and a specificity of 70.00%.Conclusion IFIT3 and ORM1 might be potential biomarkers for discriminating active TB from latent TB infection.展开更多
Preventive treatment has an essential effect on latent tuberculosis infection(LTBI)[purified protein derivative(PPD)induration≥15 mm].Between2010 and 2013,there were 6 tuberculosis(TB)outbreaks in the universities in...Preventive treatment has an essential effect on latent tuberculosis infection(LTBI)[purified protein derivative(PPD)induration≥15 mm].Between2010 and 2013,there were 6 tuberculosis(TB)outbreaks in the universities in Dalian,China.So far,in Dalian,the directly observed therapy(DOT)and展开更多
Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Sev...Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Several factors are known to sustain that process.Schistosoma mansoni, a parasite of the helminth genus that possesses switching power from an immune profile type Th1 to Th2 that favors reactivation of latent TB bacteria. The aim of the study was to assess the prevalence of the co-infection between the two endemic infections. Systematic literature was contacted at the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. Original articles were included, and full texts were reviewed to assess the prevalence and better understand the immunological changes that occur during the co-infection. In total, 3530 original articles were retrieved through database search, 53 were included in the qualitative analysis, and data from 10 were included in the meta-analysis. Prevalence of the co-infection ranged from 4% to 34% in the literature. Most of the articles reported that immunity against infection with helminth parasite and more specifically Schistosoma mansoni infection enhances latent TB reactivation through Th1/Th2. In sum, the impact of Schistosoma mansoni co-infection with Mycobacterium tuberculosis is under-investigated. Understanding the role of this endemic tropical parasite as a contributing factor to TB epidemiology and burden could help integrate its elimination as one of the strategies to achieve the END-TB objectives by the year 2035.展开更多
Objective: This study aimed to determine prevalence of latent tuberculosis infection among medical students and tuberculosis exposure at the health facilities. Methods: A cross-section of study year 1(n=68) and year 5...Objective: This study aimed to determine prevalence of latent tuberculosis infection among medical students and tuberculosis exposure at the health facilities. Methods: A cross-section of study year 1(n=68) and year 5(n=75) medical students in a local university were recruited for latent tuberculosis infection testing using QuantiFERON-TB Gold Plus and a questionnaire analyzed for multivariate risk. Results: The majority of the study were vaccinated with BCG. None of year 1 medical students were positive for latent tuberculosis infection, however, six(8.0%) year 5 students were tested positive for latent tuberculosis infection. A higher incidence of year 5 medical students claimed to be exposed to tuberculosis at health facility(65.3% vs. 4.4%) and a higher percentage reported contact with tuberculosis case over the preceding year compared to year 1 students(30.7% vs. 8.8%). Conclusion: We observed a higher incidence of latent tuberculosis infection and higher exposure to tuberculosis in health facilities among year 5 medical students. Baseline screening and monitoring for progression to tuberculosis infection may benefit tuberculosis management programs.展开更多
Introduction: Tuberculosis is a major health problem in developing countries including Sudan. Screening for TB cases through Household contacts (HHCs) investigation is an appropriate strategy to interrupt transmission...Introduction: Tuberculosis is a major health problem in developing countries including Sudan. Screening for TB cases through Household contacts (HHCs) investigation is an appropriate strategy to interrupt transmission of TB. Objectives: To determine the prevalence tuberculosis infection and risk factors for tuberculosis infection among household contacts in Wadimadani locality, Central State, Sudan, between November 2015 and April 2016. Methods: An analytical cross-sectional study conducted. During study period, to confirm TB diagnosis, all suspect contacts were tested through sputum samples, tuberculin skin test or chest X-ray. Structured questionnaire was used to collect socio-demographic and environmental factors. Results: One hundred forty six patients of smear-positive pulmonary tuberculosis were included in the study, 657 household contacts were identified and screened. Forty three new TB cases were detected from household contacts, yielding a prevalence of 6.5% (95% confidence interval = 0.05, 0.09) of latent tuberculosis infection (LTBI). Two factors were significantly associated with LTBI among HHCs: duration of contact with a TB patient ≤ 4 months (P = 0.03) and the educational status (P = 0.02). Conclusion: Screening of HHCs of index case of TB will contribute in early detection and treatment of new cases, and considered as a forward step towards eliminating TB.展开更多
The aim of this study was to analyze the combination of three kinds of in-house IFN-γ ELISPOT using peptide A53 and peptide mixtures (E6 + E7 and E6 + E7 + C14) with tuberculin skin test (TST) to detect latent TB inf...The aim of this study was to analyze the combination of three kinds of in-house IFN-γ ELISPOT using peptide A53 and peptide mixtures (E6 + E7 and E6 + E7 + C14) with tuberculin skin test (TST) to detect latent TB infection (LTBI) in China. A total of 788 healthy people were recruited and analyzed by three kinds of IFN-g ELISPOT, 581 of them had TST results, of which 147 samples were also compared with the T- SPOT.TB test. The positive detection rates for T- SPOT.TB and three kinds of IFN-γ ELISPOT with A53, E6 + E7 and E6 + E7 + C14 were 14.28% (21/147), 29.43% (171/581), 23.24% (135/581) and 28.40% (165/581), respectively. These results were significantly lower than the positive TST results, which were positive in 82.99% (122/147) and 75.73% (440/ 581), respectively. The positive detection rates of three kinds of IFN-γ ELISPOT (31.60%, 26.65% and 32.11% in 788 cases, respectively) could better reflect over 40.00% of Mycobacterium tuberculosis (MTB) infection rate in China. Detection rates between contacts and non-contacts by three kinds of IFN-γ ELIS-POT were not significantly different (p > 0.05). It can be seen that the three kinds of in-house IFN-γ ELIS- POT might be used as a complementary tool of T- SPOT.TB for detecting LTBI in the healthy population of China.展开更多
Most people with latent Mycobacterium tuberculosis infection can partly develop active tuberculosis (TB). Therefore, diagnosis of this condition bears significance in early TB prevention. To date, the main methods for...Most people with latent Mycobacterium tuberculosis infection can partly develop active tuberculosis (TB). Therefore, diagnosis of this condition bears significance in early TB prevention. To date, the main methods for diagnosis of latent TB infection (LTBI) include tuberculin skin test and interferon γ release test. These two methods feature their own advantages and disadvantages. Although new diagnostic markers continually emerge, no uniform diagnostic criteria are available for TB detection. This study summarizes several methods for diagnosis of LTBI and new related markers and their application value in clinical practice.展开更多
Background:Diagnosing latent tuberculosis(TB)infection(LTBI)and active TB(ATB)is crucial for preventing disease progression and transmission.However,current diagnostic tests have limitations in terms of accuracy and s...Background:Diagnosing latent tuberculosis(TB)infection(LTBI)and active TB(ATB)is crucial for preventing disease progression and transmission.However,current diagnostic tests have limitations in terms of accuracy and sensitivity,making it challenging to diagnose these different infection states.Therefore,this study intends to develop a promising biomarker for LTBI and ATB diagnosis to overcome the limitations of the current diagnostic tests.Methods:We developed a novelmultiepitope-based diagnostic biomarker(MEBDB)fromLTBI region of differentiation antigens using bioinformatics and immunoinformatics.Immune responses induced byMEBDM were detected using enzyme-linked immunosorbent spot and cytometric bead assays.This study was conducted from April 2022 to December 2022 in the SeniorDepartment of Tuberculosis at the 8thMedical Center of PLA General Hospital,China.Blood samples were collected from participants with ATB,individuals with LTBI,and healthy controls(HCs).The diagnostic efficacy of MEBDB was evaluated using receiver operating characteristic curves.Results:A novel MEBDB,designated as CP19128P,was generated.CP19128P comprises 19 helper T lymphocyte epitopes,12 cytotoxic T lymphocyte epitopes,and 8 B-cell epitopes.In silico simulations demonstrated that CP19128P possesses strong affinity for Toll-like receptors and elicits robust innate and adaptive immune responses.CP19128P generated significantly higher levels of tumor necrosis factor(TNF-α),interleukin 4(IL-4),and IL-10 in ATB patients(n=7)and LTBI(n=8)individuals compared with HCs(n=62)(P<0.001).Moreover,CP19128P-induced specific cytokines could be used to discriminate LTBI and ATB from healthy subjects with high sensitivity and specificity.Combining IL-2 with IL-4 or TNF-α could differentiate LTBI from HCs(the area under the receiver operating characteristic curve[AUC],0.976[95% confidence interval[CI],0.934-1.000]or 0.986[0.956-1.000]),whereas combining IL-4 with IL-17A or TNF-α could differentiate ATB from HCs(AUC,0.887[0.782-0.993]or 0.984[0.958-1.000]).Conclusions:Our study revealed that CP19128P is a potential MEBDBfor the diagnosis of LTBI andATB.Our findings suggest a promising strategy for developing novel,accurate,and sensitive diagnostic biomarkers and identifying new targets for TB diagnosis and management.展开更多
BACKGROUND Patients undergoing solid organ transplantation,particularly those who live or have lived in tuberculosis(TB)endemic areas,are at a high risk of developing TB.The majority of post-transplantation TB cases a...BACKGROUND Patients undergoing solid organ transplantation,particularly those who live or have lived in tuberculosis(TB)endemic areas,are at a high risk of developing TB.The majority of post-transplantation TB cases are associated with reactivation of latent TB infection(LTBI).Brazil is in a single position with overlapping areas of high TB endemicity and high transplant activity.In liver transplant(LT),one should be aware of the potential hepatotoxicity associated with the treatment regimens for LTBI.AIM To evaluate the frequency of LTBI in LT patients and treatment-related issues.METHODS This was a retrospective analysis of a cohort of cirrhotic patients aged≥18 years,who underwent LT at a high-complexity teaching hospital from January 2005 to December 2012.RESULTS Overall,429 patients underwent LT during the study period.Of these,213(49.7%)underwent the tuberculin skin test(TST)during the pre-transplant period,and 35(16.4%)of them had a positive result.The treatment for LTBI was initiated after LT in 12(34.3%)of the TST-positive patients;in 3(25.0%),treatment was maintained for at least 6 mo.CONCLUSION The prevalence of LTBI was lower than expected.Initiation and completion of LTBI treatment was limited by difficulties in the management of these special patients.展开更多
Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants ...Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.展开更多
文摘Objective:Health-care workers(HCWs)are known to be at high risk for occupational biological hazards,and this includes exposure to mycobacterium tuberculosis(TB)which can result in either active or latent TB infection(LTBI).This study aims to provide an overview of the incidence of LTBI among HCWs in Brunei Darussalam,to examine associated risk factors,and to evaluate LTBI treatment compliance.Materials and Methods:This is a retrospective cross-sectional study which was conducted using data from January 2018 to December 2021,on notified cases of LTBI in HCWs which identified 115 cases.Demographic data,underlying medical conditions,and compliance to treatment were assessed through reviews of their electronic health records.Results:The incidence of LBTI was 14.6/year/1000 HCWs.The incidence rate reached a high of 24.6/1000 in 2020,and majority of cases were in the older age groups.There was good treatment acceptance and compliance(82.6%),and this was observed to be significantly higher in females than males(P=0.02).Conclusion:This study showed an average incidence of LTBI of 14.6/1000 HCWs over 4 years and high LTBI treatment acceptance(82.6%)and compliance.Emphasis on infection prevention and control measures in health-care settings and actions to increase awareness of LTBI are crucial interventions toward reducing the burden of LTBI.
文摘Objective:This paper aims to explore the effect of individualized nursing intervention on patients with active tuberculosis(ATB)and latent tuberculosis infection(LTBI).Methods:The nursing study started in January 2020 and ended in January 2023.A total of 60 patients with ATB and LTBI were included,and they were divided into two groups according to the intervention schemes selected for control testing,each with 30 cases.The intervention program selected for group A was routine care,and for group B was individualized nursing.The proportion of adverse reactions,changes in the level of lung items,self-management outcomes and satisfaction were evaluated and compared.Results:After evaluating the proportion of adverse reactions,the total proportion of ATB and LTBI in group B was lower than that in group A(P<0.05).Based on the evaluation and testing of the expiratory flow(EF),expiratory volume(EV),and vital capacity(VC)after the intervention,these levels in group B showed higher outcomes than those in group A(P<0.05).The scores in terms of living habits,sleep,diet,and compliance in group B were higher than those in group A(P<0.05).The total proportion of the satisfaction of ATB and LTBI patients in group B was higher than that in group A(P<0.05).Conclusion:After the intervention of individualized nursing measures in patients with ATB and LTBI,it was found that it can not only play a positive role in the prevention and control of adverse reactions,but also improve their lung function,and promote their self-management,with good satisfaction level,thus it has high research and clinical application values.
文摘<b><span style="font-family:Verdana;">Introduction: </span></b><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">The diagnosis of latent tuberculosis infection (LTBI) is based on secular ways: chest radiography and tuberculin skin test (TST). In front of a recent enthusiasm for LTBI, this paper reports a historical perspective of this concept. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Bibliometric analysis and literature review from medi</span><span style="font-family:Verdana;">cal databases, using the terms “latent tuberculosis infection (“LTBI”), “prim</span><span style="font-family:Verdana;">ary tuberculosis”, “tuberculin skin test”, “tuberculosis”, and from reference books on tuberculosis. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">In the PubMED/MEDLINE search for LTBI, a total of 7787 articles were found between 1901 and 2020, 95% </span><span style="font-family:Verdana;">from 2000 to 2020. In the first part of the 20</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century, </span><span style="font-family:Verdana;">LTBI term was used for sub-clinical tu</span><span><span style="font-family:Verdana;">berculosis disease, the latency being also called “</span><i><span style="font-family:Verdana;">primary tuberculosis</span></i><span style="font-family:Verdana;">” or <i>“</i></span><i><i><span style="font-family:Verdana;">ab</span></i></i></span><i><i><span style="font-family:Verdana;">ortive tuberculosis infection</span></i><span style="font-family:Verdana;">”</span></i>. <span style="font-family:Verdana;">From 1960, randomized prospective therapeutic studies mentioned </span></span><span><i></i></span><i><span style="font-family:Verdana;">“</span><i><span style="font-family:Verdana;">tuberculosis chemoprophylaxis</span></i><span style="font-family:Verdana;">”</span></i><span style="font-family:Verdana;">. By the end of the 20</span></span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century,</span><span style="font-family:Verdana;"> the epidemic of AIDS impeded tuberculosis decrease, making LTBI </span><span><span style="font-family:Verdana;">search more efficient. In 2000, the <i></i></span><i><i><span style="font-family:Verdana;">American Thoracic Society</span></i></i></span><i><span style="font-family:Verdana;"></span></i></span><span><span style="font-family:Verdana;"> and the <i></i></span><i><i><span style="font-family:Verdana;">Center</span></i></i></span><i><i><span style="font-family:Verdana;">s </span><span style="font-family:Verdana;">for Disease Controls and Prevention</span></i><span style="font-family:Verdana;"></span></i><i><span> </span></i><span style="font-family:Verdana;">proposed the systematic used of LTBI, rel</span><span style="font-family:Verdana;">ayed through public health policies. A significant higher scientific produc</span><span style="font-family:Verdana;">tion about LT</span><span style="font-family:Verdana;">BI was noted, supported by IGRA tests comm</span><span><span style="font-family:Verdana;">ercialization. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In the recent years, health public policies, combined with epidemiologic and economic factors, strengthened the use of LTBI terminology.</span></span>
基金“Plan Nacional de I+D+I”Instituto de Salud Carlos III(Fondo de Investigaciones Sanitarias [FIS] PI14/00174)+1 种基金ubdirección General de Redes y Centros de Investigación Cooperativa,Spanish Ministry of Science,Innovation and Universities,Spanish Network for Research in Infectious Diseases(REIPI RD16/0016)cofinanced by the European Development Regional Fund(EDRF)"A way to achieve Europe"
文摘Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates.
基金supported by the National Key Science&Technology project against major infectious diseases[No.2017ZX10105012]the Fourth Round of Three-Year Public Health Action Plan of Shanghai,China[No.15GWZK0101]
文摘Student contacts of tuberculosis(TB)cases are susceptible to latent tuberculosis infection(LTBI),and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment.
基金supported by grants from the Thirteen-Fifth Mega-Scientific Project on“Prevention and Treatment of AIDS,Viral Hepatitis and Other Infectious Diseases”(No.2017ZX10201301-007-002)the National Natural Science Foundation of China(No.82072233).
文摘Objective Current commercially available immunological tests cannot be used for discriminating active tuberculosis(TB)from latent TB infection.To evaluate the value of biomarker candidates in the diagnosis of active TB,this study aimed to identify differentially expressed genes in peripheral blood mononuclear cells(PBMCs)between patients with active TB and individuals with latent TB infection by transcriptome sequencing.Methods The differentially expressed genes in unstimulated PBMCs and in Mycobacterium tuberculosis(Mtb)antigen-stimulated PBMCs from patients with active TB and individuals with latent TB infection were identified by transcriptome sequencing.Selected candidate genes were evaluated in cohorts consisting of 110 patients with TB,30 individuals with latent TB infections,and 50 healthy controls by quantitative real-time RT-PCR.Receiver operating characteristic(ROC)curve analysis was performed to calculate the diagnostic value of the biomarker candidates.Results Among the differentially expressed genes in PBMCs without Mtb antigen stimulation,interferon-induced protein with tetratricopeptide repeats 3(IFIT3)had the highest area under curve(AUC)value(0.918,95%CI:0.852-0.984,P<0.0001)in discriminating patients with active TB from individuals with latent TB infection,with a sensitivity of 91.86%and a specificity of 84.00%.In Mtb antigen-stimulated PBMCs,orosomucoid 1(ORM1)had a high AUC value(0.833,95%CI:0.752-0.915,P<0.0001),with a sensitivity of 81.94%and a specificity of 70.00%.Conclusion IFIT3 and ORM1 might be potential biomarkers for discriminating active TB from latent TB infection.
文摘Preventive treatment has an essential effect on latent tuberculosis infection(LTBI)[purified protein derivative(PPD)induration≥15 mm].Between2010 and 2013,there were 6 tuberculosis(TB)outbreaks in the universities in Dalian,China.So far,in Dalian,the directly observed therapy(DOT)and
文摘Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Several factors are known to sustain that process.Schistosoma mansoni, a parasite of the helminth genus that possesses switching power from an immune profile type Th1 to Th2 that favors reactivation of latent TB bacteria. The aim of the study was to assess the prevalence of the co-infection between the two endemic infections. Systematic literature was contacted at the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. Original articles were included, and full texts were reviewed to assess the prevalence and better understand the immunological changes that occur during the co-infection. In total, 3530 original articles were retrieved through database search, 53 were included in the qualitative analysis, and data from 10 were included in the meta-analysis. Prevalence of the co-infection ranged from 4% to 34% in the literature. Most of the articles reported that immunity against infection with helminth parasite and more specifically Schistosoma mansoni infection enhances latent TB reactivation through Th1/Th2. In sum, the impact of Schistosoma mansoni co-infection with Mycobacterium tuberculosis is under-investigated. Understanding the role of this endemic tropical parasite as a contributing factor to TB epidemiology and burden could help integrate its elimination as one of the strategies to achieve the END-TB objectives by the year 2035.
文摘Objective: This study aimed to determine prevalence of latent tuberculosis infection among medical students and tuberculosis exposure at the health facilities. Methods: A cross-section of study year 1(n=68) and year 5(n=75) medical students in a local university were recruited for latent tuberculosis infection testing using QuantiFERON-TB Gold Plus and a questionnaire analyzed for multivariate risk. Results: The majority of the study were vaccinated with BCG. None of year 1 medical students were positive for latent tuberculosis infection, however, six(8.0%) year 5 students were tested positive for latent tuberculosis infection. A higher incidence of year 5 medical students claimed to be exposed to tuberculosis at health facility(65.3% vs. 4.4%) and a higher percentage reported contact with tuberculosis case over the preceding year compared to year 1 students(30.7% vs. 8.8%). Conclusion: We observed a higher incidence of latent tuberculosis infection and higher exposure to tuberculosis in health facilities among year 5 medical students. Baseline screening and monitoring for progression to tuberculosis infection may benefit tuberculosis management programs.
文摘Introduction: Tuberculosis is a major health problem in developing countries including Sudan. Screening for TB cases through Household contacts (HHCs) investigation is an appropriate strategy to interrupt transmission of TB. Objectives: To determine the prevalence tuberculosis infection and risk factors for tuberculosis infection among household contacts in Wadimadani locality, Central State, Sudan, between November 2015 and April 2016. Methods: An analytical cross-sectional study conducted. During study period, to confirm TB diagnosis, all suspect contacts were tested through sputum samples, tuberculin skin test or chest X-ray. Structured questionnaire was used to collect socio-demographic and environmental factors. Results: One hundred forty six patients of smear-positive pulmonary tuberculosis were included in the study, 657 household contacts were identified and screened. Forty three new TB cases were detected from household contacts, yielding a prevalence of 6.5% (95% confidence interval = 0.05, 0.09) of latent tuberculosis infection (LTBI). Two factors were significantly associated with LTBI among HHCs: duration of contact with a TB patient ≤ 4 months (P = 0.03) and the educational status (P = 0.02). Conclusion: Screening of HHCs of index case of TB will contribute in early detection and treatment of new cases, and considered as a forward step towards eliminating TB.
文摘The aim of this study was to analyze the combination of three kinds of in-house IFN-γ ELISPOT using peptide A53 and peptide mixtures (E6 + E7 and E6 + E7 + C14) with tuberculin skin test (TST) to detect latent TB infection (LTBI) in China. A total of 788 healthy people were recruited and analyzed by three kinds of IFN-g ELISPOT, 581 of them had TST results, of which 147 samples were also compared with the T- SPOT.TB test. The positive detection rates for T- SPOT.TB and three kinds of IFN-γ ELISPOT with A53, E6 + E7 and E6 + E7 + C14 were 14.28% (21/147), 29.43% (171/581), 23.24% (135/581) and 28.40% (165/581), respectively. These results were significantly lower than the positive TST results, which were positive in 82.99% (122/147) and 75.73% (440/ 581), respectively. The positive detection rates of three kinds of IFN-γ ELISPOT (31.60%, 26.65% and 32.11% in 788 cases, respectively) could better reflect over 40.00% of Mycobacterium tuberculosis (MTB) infection rate in China. Detection rates between contacts and non-contacts by three kinds of IFN-γ ELIS-POT were not significantly different (p > 0.05). It can be seen that the three kinds of in-house IFN-γ ELIS- POT might be used as a complementary tool of T- SPOT.TB for detecting LTBI in the healthy population of China.
文摘Most people with latent Mycobacterium tuberculosis infection can partly develop active tuberculosis (TB). Therefore, diagnosis of this condition bears significance in early TB prevention. To date, the main methods for diagnosis of latent TB infection (LTBI) include tuberculin skin test and interferon γ release test. These two methods feature their own advantages and disadvantages. Although new diagnostic markers continually emerge, no uniform diagnostic criteria are available for TB detection. This study summarizes several methods for diagnosis of LTBI and new related markers and their application value in clinical practice.
基金supported by the BeijingMunicipal Science&Technology Commission(7212103)the Eighth Medical Center of PLA General Hospital(MS202211002).
文摘Background:Diagnosing latent tuberculosis(TB)infection(LTBI)and active TB(ATB)is crucial for preventing disease progression and transmission.However,current diagnostic tests have limitations in terms of accuracy and sensitivity,making it challenging to diagnose these different infection states.Therefore,this study intends to develop a promising biomarker for LTBI and ATB diagnosis to overcome the limitations of the current diagnostic tests.Methods:We developed a novelmultiepitope-based diagnostic biomarker(MEBDB)fromLTBI region of differentiation antigens using bioinformatics and immunoinformatics.Immune responses induced byMEBDM were detected using enzyme-linked immunosorbent spot and cytometric bead assays.This study was conducted from April 2022 to December 2022 in the SeniorDepartment of Tuberculosis at the 8thMedical Center of PLA General Hospital,China.Blood samples were collected from participants with ATB,individuals with LTBI,and healthy controls(HCs).The diagnostic efficacy of MEBDB was evaluated using receiver operating characteristic curves.Results:A novel MEBDB,designated as CP19128P,was generated.CP19128P comprises 19 helper T lymphocyte epitopes,12 cytotoxic T lymphocyte epitopes,and 8 B-cell epitopes.In silico simulations demonstrated that CP19128P possesses strong affinity for Toll-like receptors and elicits robust innate and adaptive immune responses.CP19128P generated significantly higher levels of tumor necrosis factor(TNF-α),interleukin 4(IL-4),and IL-10 in ATB patients(n=7)and LTBI(n=8)individuals compared with HCs(n=62)(P<0.001).Moreover,CP19128P-induced specific cytokines could be used to discriminate LTBI and ATB from healthy subjects with high sensitivity and specificity.Combining IL-2 with IL-4 or TNF-α could differentiate LTBI from HCs(the area under the receiver operating characteristic curve[AUC],0.976[95% confidence interval[CI],0.934-1.000]or 0.986[0.956-1.000]),whereas combining IL-4 with IL-17A or TNF-α could differentiate ATB from HCs(AUC,0.887[0.782-0.993]or 0.984[0.958-1.000]).Conclusions:Our study revealed that CP19128P is a potential MEBDBfor the diagnosis of LTBI andATB.Our findings suggest a promising strategy for developing novel,accurate,and sensitive diagnostic biomarkers and identifying new targets for TB diagnosis and management.
基金The study was approved by the Federal University of Minas Gerais Research Ethics Committee(approval number:0614.0.203.000-11).
文摘BACKGROUND Patients undergoing solid organ transplantation,particularly those who live or have lived in tuberculosis(TB)endemic areas,are at a high risk of developing TB.The majority of post-transplantation TB cases are associated with reactivation of latent TB infection(LTBI).Brazil is in a single position with overlapping areas of high TB endemicity and high transplant activity.In liver transplant(LT),one should be aware of the potential hepatotoxicity associated with the treatment regimens for LTBI.AIM To evaluate the frequency of LTBI in LT patients and treatment-related issues.METHODS This was a retrospective analysis of a cohort of cirrhotic patients aged≥18 years,who underwent LT at a high-complexity teaching hospital from January 2005 to December 2012.RESULTS Overall,429 patients underwent LT during the study period.Of these,213(49.7%)underwent the tuberculin skin test(TST)during the pre-transplant period,and 35(16.4%)of them had a positive result.The treatment for LTBI was initiated after LT in 12(34.3%)of the TST-positive patients;in 3(25.0%),treatment was maintained for at least 6 mo.CONCLUSION The prevalence of LTBI was lower than expected.Initiation and completion of LTBI treatment was limited by difficulties in the management of these special patients.
文摘Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.